Sheriff's deputies hold Isaac Zamora as he appears in Skagit County district court Wednesday, Sept. 3, 2008, in Mount Vernon, Wash. Zamora is accused in a shooting and stabbing rampage Tuesday that left six people dead and four wounded. Judge David Svaren prohibited photographers from showing Zamora's face during his brief appearance. (AP Photo/Ted S. Warren)

SEATTLE — Isaac Zamora's mother begged him to get help when he was released from jail a month ago. State and federal laws prevented her from doing much more for the man who has now been arrested after a shooting spree in rural northwest Washington that left six people dead and four wounded.

The Tuesday afternoon rampage began close to the home of Zamora's mother, Dennise Zamora, near Alger, about 70 miles north of Seattle. It continued amid a high-speed police pursuit on Interstate 5 and ended in Mount Vernon, about 20 miles south of Alger, when Zamora surrendered at a sheriff's office.

In the wake of the shootings, Dennise Zamora has said she wants people to know that "my son was desperately mentally ill and we've been trying to get him help."

If someone resists help in Washington, a family member must demonstrate he is a danger to society or himself or is "gravely disabled" before he can be involuntarily admitted to a mental hospital.

Washington's laws offer more options for involuntary commitment than most other states, said Ron Honberg, legal director of the Arlington, Va.-based National Alliance on Mental Illness. But Washington families still can't petition in court for their adult relatives to get treatment.

The laws were designed to protect the rights of the individual, explains David Weston, chief of mental health services with the mental health division of the Washington Department of Social and Health Services.

Many states, including Washington, also struggle to pay for mental health services.

That might be part of the explanation why Zamora, who was ordered by a judge to seek a mental health evaluation as soon as he was released from jail in August, had not yet seen a counselor. He served six months for cocaine possession.

His evaluation was delayed while his parole officer tried to find money to pay for it, said Chad Lewis, spokesman for the state Department of Corrections, which was supervising Zamora after his release.

Zamora, 28, is being held on $5 million bail for investigation of murder and attempted murder.

According to friends and family, the gunman had been in and out of hospitals over the years, seeking help for mental illness.

In Zamora's case, the treatment was mostly involuntary, but Weston said the majority of mental health services are provided to people who ask for help.

Fewer than one-third of adults with a diagnosable mental disorder receive any mental health services in a given year, according to a U.S. Department of Health and Human Services report on mental health.

Honberg called it a sad irony that in most cases, the 8.1 million adults with schizophrenia or bipolar disorder in the United States are being cared for by their families, who have no legal standing.

Friends of Zamora said he had been diagnosed with both mental illnesses, but state officials would not say if such a diagnosis was part of his file.

Forcing an adult to get mental health services requires a complicated legal process in every state, and an appeal by a family member is not usually the most effective way to get that help.

"It's not unusual at all for the initial contact to be with law enforcement," Weston said. "911 is often the right place to start."

Family members may be more successful at getting their loved ones help for a mental disorder if they try an approach other than pleading or badgering, said Dr. Xavier Amador, author of a guide for getting treatment for a family member. Half of the people with schizophrenia or bipolar disorder in this country don't understand they are ill, Amador said.

Instead of trying to change the person's mind about treatment, family and friends can listen to the person's concerns and find a common area of agreement that can lead to the same result.

For example, the person may agree to treatment to keep the police away from their front door or may be willing to take medications as a way to avoid going to the hospital.

Amador, who said the method has been taught to families, health care providers and law enforcement officials around the world and helped get his own brother, who suffers from mental illness, into treatment.

"It's really pretty simple if you think about it," he said.

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